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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Acute kidney failure

Kidney failure; Renal failure; Renal failure - acute; ARF; Kidney injury - acute

Last reviewed: September 5, 2012.

Acute kidney failure is the rapid  loss your kidneys' ability to remove waste and help balance fluids and  electrolytes in your body. In this case, rapid means less than 2 days.

Causes, incidence, and risk factors

There are many possible causes of kidney damage. They include:

Symptoms

Signs and tests

The doctor or nurse will examine you. Many patients with kidney disease have body swelling caused by fluid retention. The doctor may hear a heart murmur, crackles in the lungs, or other abnormal sounds when listening to the heart and lungs with a stethoscope.

The results of laboratory tests may change suddenly (within a few days to 2 weeks). Such tests may include:

A kidney or abdominal ultrasound is the preferred test for diagnosing a blockage in the urinary tract. X-ray, CT scan, or MRI of the abdomen can also tell if there is a blockage.

Blood tests may help reveal the underlying cause of kidney failure. Arterial blood gas and blood chemistries may show metabolic acidosis.

Treatment

Once the cause is found, the goal of treatment is to help your kidneys work again and prevent fluid and waste from building up in the body while they heal. Usually, you have to stay overnight in the hospital for treatment.

The amount of liquid you eat (such as soup) or drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the buildup of toxins that the kidneys would normally remove. Your diet may need to be high in carbohydrates and low in protein, salt, and potassium.

You may need antibiotics to treat or prevent infection. Diuretics ("water pills") may be used to help remove fluid from your body.

Medicines will be given through a vein to help control your blood potassium level.

Dialysis may be needed for some patients, and can make you feel better. It can save your life if your potassium levels are dangerously high. Dialysis will also be used if:

  • Your mental status changes, if you stop urinating
  • You develop pericarditis
  • You retain too much fluid
  • You cannot eliminate nitrogen waste products from your body

Dialysis will most often be short term. Rarely, the kidney damage is so great that dialysis may be permanently needed.

Support Groups

The stress of having an illness can often be helped by joining a support group where members share common experiences and problems.

See: Kidney disease - support group

Calling your health care provider

Call your health care provider if your urine output slows or stops or you have other symptoms of acute kidney failure.

Prevention

Treating disorders such as high blood pressure can help prevent acute kidney failure.

References

  1. Molitoris BA. Acute kidney injury. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 122.
  2. Sharfuddin AA, Weisbord SD, Palevsky PM, Molitoris BA. Acute kidney injury. In: Taal MW, Chertow GM, et al, eds. Brenner & Rector's The Kidney. 9th ed. Philadelphia, PA: SaundersElsevier; 2011:chap 30.

Review Date: 9/5/2012.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Herbert Y. Lin, MD, PHD, Nephrologist, Massachusetts General Hospital; Associate Professor of Medicine, Harvard Medical School.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

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  • Tidal versus other forms of peritoneal dialysis for patients with acute kidney injuryTidal versus other forms of peritoneal dialysis for patients with acute kidney injury
    Acute kidney injury (AKI) is characterised by a sudden decline in kidney filtration and patients with AKI have reduced (or no) urine output. AKI is clinically defined by an increase in serum creatinine and decrease in glomerular filtration rate. People with AKI need renal replacement therapy usually in the form of kidney dialysis. At present, there is no universally accepted form of dialysis for most AKI patients. Peritoneal dialysis (PD) has been favoured because it causes fewer heart and lung problems, and patients do not need anti‐clotting drugs. Tidal PD (TPD) is an automated process that fills and drains the dialysis fluid, but retains a designated proportion so the peritoneum never completely empties.
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